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DPH update: Ebola monitoring continues; Shigella outbreak linked to SRO/homeless populations; measles cases rise statewide
Summary
DPH reported ongoing Ebola traveler monitoring (about 30 people), a Shigella outbreak with 181 local cases disproportionately affecting homeless and SRO residents and showing antibiotic resistance, and 113 measles cases statewide so far; San Francisco reported no confirmed resident cases tied to the outbreak at the time.
Dr. Cora Hoover, director of Communicable Disease Control and Prevention, briefed the Health Commission on current infectious'disease issues affecting San Francisco and the region.
Ebola: DPH continues to follow CDC guidance for identifying and monitoring travelers returning from Ebola'affected countries. Dr. Hoover described a 21'day monitoring process after return, with nurse monitoring and health'officer orders as needed; the department has monitored about 30 individuals over recent months.
Shigella outbreak: DPH reported an outbreak of shigellosis that began in November and peaked in December. "We've had 181 cases associated with this outbreak," Dr. Hoover said, and noted the bacterium involved is resistant to one commonly used antibiotic. The outbreak has disproportionately affected people who are homeless or living in residential hotels or single'room'occupancy units; DPH has worked with homeless'service providers, distributed more than 20,000 hygiene items (hand sanitizer and towelettes) and conducted environmental inspections of food facilities serving homeless clients.
Measles: Dr. Hoover said California was experiencing a measles outbreak that began in late December 2014 and was slowing but ongoing; when the slides were submitted there were about 100 cases statewide and the number rose to 113 by the time of the meeting. San Francisco had not yet confirmed a measles case associated with the statewide outbreak but public'health staff were conducting extensive testing and outreach. DPH and the San Francisco Unified School District are coordinating to provide free measles vaccine doses through school clinics for students not up to date.
Seasonal influenza: The department said influenza activity appeared to be slowing but that the 2014'2015 season looked to be moderate'to'severe with a vaccine effectiveness reduction because of an H3N2 strain mismatch; older adults were particularly affected and the department has responded to multiple long'term'care outbreaks.
Commissioners thanked DPH for rapid messaging and discussed vaccine policy, outreach, and the department's role in removing barriers to immunization for children (for example, Vaccines for Children enrollment and school'clinic partnerships).
